Best Team Nominations

Winner:

Team BrisDoc is the best. We are nominating the entire team because the whole is greater than the sum of its parts (and the parts are strong). BrisDoc is known for its quality, reliability, innovation and effectiveness. Our motto is “Patient care by people who care”, which has real tangible impact, accentuated by becoming employee-owned in 2021. We are a high profile, central ‘player’, leaders in novel collaborative working, risk and culture. We were recently shortlisted for three HSJ awards in these spheres (ceremony 15 Sept).

BrisDoc co-led the development of Clinical Guardian. It is now widely used by UHUK organisations, has been the subject of an academic paper (ref available), and described by CQC as ‘outstanding’. Our governance is further strengthened by an open, supportive environment. We endorse a proactive learning culture and have coined the terms “fear-based medicine” and “courage-based medicine”. We deliver workshops for GPs, trainees and others on risk, fear and courage. One is called, “Things that go bump in the night”, in which participants discuss cases which kept them awake at night, and share stories and fears. These have been popular and cathartic, with one young GP commenting, “more useful for resilience than resilience training”.

The Integrated Governance Framework, developed by BrisDoc for the System CAS (see separate submission), has been adopted for other initiatives, eg. the Covid Medicines Delivery Unit and Healthier Together at Home. It is now the template for a systemwide Governance Framework.

A novel communication skills course has been created, called “Make Every Comma Count”. It aims to improve and refine professional communication, focussing in-depth on written and verbal communication, dealing with conflict and storytelling. This is combined with an emphasis on coaching: one of our Deputy Medical Directors is a qualified coach. We are training all line managers in basic coaching skills and enabling in-depth coaching for senior leaders.

BrisDoc has performed strongly in multiple surveys, and not just in urgent care. For example, Audit South West Assurance (NHS) reviewed all our services recently and awarded a rating of “Excellent”. 

Employee ownership is progressing well. A vibrant Staff Council has been formed and an Independent Director appointed (the CEO of a local travel company, itself a social enterprise). Employee Director appointments are underway. The Staff Council is already
making an active contribution, with ideas for growth and further innovation.

In sum, Team BrisDoc is the best: energetic, ambitious, innovative - and always caring.

Our Control Team are a fantastic team who we are exceptionally proud of. 
Between them they manage and provide support to the whole CHoC team working both in, and out of hours providing a caring and reactive response to the patients of Cumbria.  The team and the demands on them have grown year on year and instead of failing to adapt to this constant change the team have thrived.  They go from strength to strength, adapting and working with the Operational and Digital Managers to ensure that they understand the numerous services we take on as an Organisation and can deliver for our stakeholders, partner organisations and of course our patients.  During COVID this team worked consistently together, despite anxieties and absence to keep the Control room running as smoothly and effectively as they could. They supported each other and took on the new challenges of adapting and learning many digital changes in order to keep patients and our clinicians safe. They continue to run an amazing Virtual Reception model, talking patients through any technical issues regardless of their backgrounds and levels of understanding. The team offer support to patients within Cumbria to enable CHoC to remotely monitor them through our pulse ox service, and they adapt readily to any spikes the virus throws our way. 

When faced with adversity on shift they react quickly and solve issues, pool resources or move resources around the county to support CHoC bases and ensure continuous delivery of the CHoC services.  Their response in a crisis is second to none, demonstrated year on year by all that Cumbria gets thrown at it, everything from the Beast from the East, Storm Desmond, Strom Eunice (and many storms in between!), not forgetting local power outages and national cyber-attacks.  Every time they respond, and they respond well! Working extra, feeding back to improve processes and supporting each other across the County.  They regularly adapt and learn to manage a whole suite of services that we offer over winter to support our health economy and do so with pride and drive.  The amount of information this team holds is staggering, and their ability to process the amounts of patient information through a number of systems to ensure good data control and a seamless service is nothing but remarkable.

Our Nursing team are an essential asset to CHoC – they account for approximately
40% of the clinical workforce.

They are experienced & knowledgeable about patient care, the CHOC service and other local/partner services. This team are invested in our local communities because they live and work here, often with other roles in partner organisations. They are reliable, flexible (in changing shifts to help the service), conscientious; and focused on giving excellent patient care. They provide consistency to our rotas and stability to our workforce.

At each base (especially West and Carlisle) the nursing team provide the main structure to the team and provide not only to each other but to the rest of the team – clinical and operational members such as receptionists and drivers. They are welcoming to new team members and provide more than just induction but a genuine welcome, offering support and friendship that goes beyond the superficial and the work place. This support is recognised by new team members and is so valuable in clinical supervision and learning from each team members particular skills and in general staff wellbeing.

The nursing team provide many different roles across the organisation in telephone triage, base, car and video consultation shifts. They are highly adaptable, resilient and have willingness to support with new and developing services ensuring the best outcome for the patient.

All teams within all organisations have had to develop and change rapidly following the covid-19 pandemic, but the nursing team within CHoC have rapidly managed the differing systems, processes and policies standing up to the challenges faced. There are some services within our organisation which would not be possible without our valued nursing team.

I would like to nominate my colleagues in the management/office team of Dalriada Urgent Care.

The team:

• Dr Tracey & Dr Johnston, Clinical Directors
• Aislinn, Lead Pharmacist
• Kathryn, Nurse manager
• Catriona & Karen, Lead nurses
• Jacqui, Finance manager
• Janet, Governance/Complaints lead
• Mary, Operations Lead
• The office staff – Sandra, Maureen, Ruth, Diane, Claire, Maria, Helga, Sam & Noel.

The leadership of this team is exemplary and a real example of how a small team of people can work together to achieve great results.  We have a management team
meeting each Tuesday where we have discussions and where each and everyone’s opinions matter.  All of the above professions contribute to ensure a smooth cross over of opinions.

Each week, we have a productive day and we continue to make decisions, achieve results and grow.

We and run a busy 24hr GP healthcare facility and manage 250 part time staff between us over three sites. The office staff are dedicated they follow the strengths and innovation shown by management.

This team has shown great strength, especially over the covid period where we set up 2 covid centres in a turnaround time of 4 weeks. The team are always willing to work above and beyond to meet our deadline and achieve our goals.

I am proud to be part of this team over the past 26 years and would love to see recognition for their hard work and dedication. These staff are my work colleagues and also my friends.

Ann Convery – CEO – Dalriada Urgent Care.

Over the past year DHU Healthcare has grown a small team that is bringing a different style of communications and engagement to the organisation.

With a new role of Deputy Director in place to lead the approach, the collective of four has embarked on a programme of brand development, awareness raising, involvement and recognition.  It has set out to showcase DHU as a place to work and as a provider of compassionate care – using the new organisational strategy as a backdrop for all its campaigns and programmes.

This constant ‘golden thread’ to link vision, mission, critical success factors and values is key – with stories, facts and information shared openly and honestly with stakeholders.  From recognising our peoples’ different cultures and beliefs, ‘shouting-out’ colleagues for their achievements and contributions, through to collaborating with system partners on public education, and developing new visual communication tools, the team has been consistently proactive throughout the last 12-months. In addition, they have addressed challenging situations through robust plans – covering everything from contract ‘step-ins’ and ‘step-outs’ to incidents and errors, responding swiftly to requests from the media.  In the recent three-week national Adastra outage incident the team set out a plan quickly, producing daily updates and briefings. And rather than simply relaying facts, they recognised the impact of the incident on our people, as well as patients and services.  The communication tone from the Chief Executive was personable and informal, which is a new-look for DHU.  Everything produced was shared with local, regional and national partners, working in-line with NHS messaging and the sensitive issue of a ‘cyber-attack’.

Throughout the year the team has been responsible for a range of new projects - including a new DHU brand logo, a new website and a recruitment campaign that resulted in hundreds of applications to NHS111 services.  They have also increased their social media following from around 2,600 followers to more than 6,000 using a combination of visual posts that include animation and video.

The biggest difference has been the engagement element the team has brought to communications.  They have involved our patients, people and partners in all their creative developments and have linked in with the DHU staff forum as well, using representatives as a sounding board.  The team speaks every day, hosts a once a month full-day planning session and works to support each other, with an element of fun thrown in!

Highly Commended:

The Primary Care Support Team was developed as a response to the Covid pandemic in March 2020 and has grown significantly in the last 2.5 years.

Initially created as a response to mutual aid requests from the CCGS across L&SC  for swabbing communities at high risk of contracting covid.  The team rose to the challenge putting aside any of their own fears, anxieties, and concerns to deliver a high-quality service to these patients.  Following this we worked with the CCG to deliver the anti-body testing for health care workers including care home staff to ensure on going safety for staff and patients across the Fylde Coast. As we continued through the pandemic, we worked with our local trust providing PCR testing for all preoperative patients and healthcare workers. We continued to do this work for over 2 years.  As life started to return to normal the local council approached us to develop LFT sites across a variety of locations across the Fylde Coast.  In June 2021 we enhanced our working relationship with the council and pharmacy colleagues to collaboratively create a roving vaccination service. This included a 7-day service at several hard-to-reach locations where vaccine uptake had been particularly low. This service continues today with staff who are as committed as they were on day 1 to deliver the autumn booster/flu campaign. 

Alongside the above, the CCG approached us again to develop a remote home monitoring service for people in the community with covid. This was to offer daily contact to vulnerable patients and offer assurance through the technology of the team at Docobo to monitor oxygen levels and general wellbeing.  The team often went above and beyond the expectation for the service offering support with shopping, medication pick up to just saying “hello “whilst patients were isolating for long periods. This service has grown immensely having cared for over 4000 patients.  As a further development and collaborative working with the trust, council, and community teams we now provide remote home monitoring for patients with Acute respiratory problems, patients on the cardiac waiting list, post STEMI / EP patients and housebound patients with long term conditions.

This team demonstrates the following attributes: responsive, enthusiastic, caring, dynamic, flexible to any working condition and environment.  Above all they have supported each other during the most challenging times of anybody’s carer always putting the patient at the forefront of their intentions. 

Our Hospital@ Home team was established in October 2021 with a group of enthusiastic highly skilled Advanced Clinical Practitioners.  Since the service went live it has made a huge difference to the support available to community teams and care homes across the integrated care system. The team have been faced with regular challenges and have managed these both professionally and with passion to get things right for our patients. They are true trail blazers with a drive and determination to make a difference.  They have become amazing role models in advanced practice in the community and it demonstrates just what is possible if we have the skills and potential to grow. This is clear in the feedback we receive from both their patients and carers but also from other community teams that have benefited from their support.

The team demonstrates proactive care and champions the ability of community practitioners and just what can be achieved if investment into primary care was directed into this area of care. Their governance and focus on safety gives the organisation assurance that while pushing the boundaries of care they continue to manage any risk and make sure care is not compromised. 

The team have also been proactive in looking for solutions to challenges that have faced them such as safe IV fluid administration in the community and managing patients with reduced venous access. This has led to testing significant change in the community and working alongside other partners such as Braun and the use of vacuum pumps that have previously been used for drug administration but can be used for slower infusions of IV or SC fluids. The team truly compliment the community services and have proved a valuable addition to the services available in the community to not only support early supported discharges but to support primary care to keep patients at home and offer an
alternative to admission.

I am confident that the formation of this service has had a real positive impact on the care offered to the people of Stockport and we are extremely proud of what they have achieved to push the boundaries of care in the community.

Highly Commended:

I would like to nominate the Covid Oximetry at Home (CO@H) monitoring Team from NHUC for the above award which was a Nurse Led service. For 2 years this small, dedicated team have worked every weekend and Bank Holiday to support the NHCCG and NEH&F CCG CO@H service until the end of March 2022. The team was quickly established from a small group of volunteers from within our service including retired nurses who returned to work during the Covid 19 Pandemic. The team have adapted well to the constant changes and challenges in delivering this service and are a credit to NHUC  and the nursing profession as they demonstrated safe ,effective and compassionate care. Roma Partington (Deputy Director of Nursing) has spent a great deal of time and effort in training staff, ensuring the policies and governance was up to date, meeting with CCGs to ensure the service runs smoothly and is safe. The nurses all embraced the challenges of working long hours with 3 IT systems, unwell patients and then having to learn another system called In Health. 

At The height of Covid earlier in 2021 the nurses were putting in 10-12 hours a day most weekends and by the end of March 2022 have manged to support over 3,200 patients which has avoided a call to OOH, hospital admission or calling an ambulance. They all demonstrated dedication to their patients and colleagues as well as to the patients by providing safe and effective care. There have also been cases where seriously ill patients have been identified and escalated to the appropriate service.

Despite their main role being CO@H the nurses who were located in the Hot Hub were also called on to assist Clinicians with unwell patients and on several occasions have helped unwell patients in the car park which has allowed Clinicians to continue to see patients with minimal disruption to the service. They also triaged calls for NHUC if they have any quiet time to support the service.

This service was completely Nurse Led and is an example of systems working together for the benefit of patient care and totally reflects NHUC values of being safe, honest, open, effective and supportive. These nurses are a complete asset to NHUC in their professional approach to a system problem. This partnership working with the CCG has led to NHUC continuing to host and support the CO@H and working with the system to support unwell patients and avoiding admission. Building on this success we are about
to pilot remote monitoring for patients with asthma and COPD who are unwell to improve the patient experience and outcome.

I would like to nominate the Asylum Service Team (AST) for the Best Team Award 2022.

Based in Liverpool, our AST is one of seven teams in the UK who provide health screening and medical assessments to asylum seekers who have recently arrived in the UK, often with little or no personal belongings. They can be based in either the Liverpool Initial Accommodation Centre (IAC) or in the Halton IAC. Although their stay in the IAC should be short term, due to the increasing numbers of asylum seekers entering the UK, the demand for finding permanent locations for asylum seekers across the UK is significantly delayed. This has an impact for those who are in our IACs as they can wait up to 12-18 months before they are moved to their final location elsewhere in the UK.

Many of the asylum seekers speak little or no English, yet the team espouse our core values by respectfully conveying and communicating with care and compassion when undertaking clinical assessments with individuals, often with the support of a translator.

The AST is small, comprising of a GP, an Advance Nurse Practitioner and three administrators. Despite this, the impact and devotion they show in delivering the service is outstanding - going above and beyond the requirements of the service to ensure they offer the best possible solutions and care to the asylum seekers. The team care passionately about the service and the people who are using the service, and regularly, and voluntarily, bring extra equipment, clothing, shoes and books to try and help some of the asylum seekers. When issues are identified through the clinical assessments, the team work tirelessly to resolve and put adjustments in place to rectify the issue. For example, recently the team identified an asylum seeker who was an insulin dependent diabetic. The team advocated on behalf of the service user to obtain an additional fridge for the service users room in the IAC to enable the insulin to be appropriately stored. In addition, the team fought hard to obtain an extra food allowance for the same service user to ensure they had adequate snacks available 24/7 should he experience a hypo episode.

Our team always goes above and beyond for the needs of the service and I am proud to be nominating our AST who deliver this highly complex service with compassion, care and humility.

The Quality team strives to ensure patient safety and experience is at the heart of everything we do. The team continuously raises the profile of continuous learning and quality improvement, and have introduced innovative ways to ensure effective learning from patient safety events. The team has a strong presence within the call centre and across our satellite sites, undertaking regular site visits, addressing any quality issues and ensuring that staff know how and what to report.

The team has developed dashboards to support operational teams in identifying key areas of concern which need to be addressed, highlighting key themes of learning, and triangulating data to provide a clearer understanding of what his happening across services, engaging staff through keeping them updated with themes and trends, and including a ‘You said, we did’ section in the newly introduced Quality Newsletter.

The team are responsive to feedback, and as a result are in the process of building an automated feedback function in the Datix system which will provide staff reporting incidents with feedback on the outcomes of the investigation once the incident is closed. We hope this will further engage staff with the quality agenda and demonstrate the value of their reporting.

The team recently introduced the use of SBARs as a quick way of reaching all staff with important information regarding incidents, which has been successfully adopted by managers throughout the organisation and has proved to be an effective way of reducing the risk associated with an incident as quickly as possible.

The team have evolved, and recognised gaps in terms of focus on Quality Improvement. The team have started several initiatives in order to address this, improving the safety mechanisms underpinning urgent and 2 week wait referrals within primary care, as well as collaborating with colleagues within the local healthcare system to reduce waiting times for patients and reducing pressure on local Accident and Emergency departments through developing a pilot paediatric triage service operational within the Out of Hours period, utilising a new clinical workforce and aiming to provide patients with the right care at the right time.

The team really try to go above and beyond to ensure that feedback received from patients forms part of an improvement plan to make services safer and more effective. The team regularly receive positive feedback from patients the management of their feedback and commitment to improving services for patients.

We want to nominate our Rota Team because they have been able to consistently safely and fully staff our rota without us having to use additional financial incentives. These are only very occasionally used and very exceptionally, such as the odd overnight shift.  As a result of their work, we have a reputation that filled rotas mean work pressure on shift is manageable which attracts additional clinicians to work for us. 

Our Rota Team are responsible for filling rotas for OOH, ED streaming and our evening/weekend additional routine appointments. In addition, various new short-term services have been mobilised throughout COVID and after in response to season pressures. Each of these additional services need to be staffed. The majority of our staff are on bank contracts so each week’s rota has to be filled and they cannot rely on
contracted staff.

Our Rota Team is small and work well under great pressure. They continuously use a problem -solving approach to achieve great rota fill to ensure our services are safe to work in and can meet the demand from the patients using the services.

The team have built great working relationships with all staff both clinical and support staff. They have the knowledge of who can work in which service, the type of shifts they prefer and there existing work commitments to work round.

The great relationships that have been formed have resulted in the Team being able to fill rotas to a high fill rate without having to use additional incentives. The Team is confident with their capabilities that we do not need to respond to clinicians asking for an enhanced rate or not booking until the last minute.